COMPLIGAM OR COMBILIPEN: which is better and what is the difference (differences in composition, reviews from doctors) Diabet doctor

The complexes are sold in tablet and injection form. The active components in both medications are three vitamins. Both Milgamma and Combilipen in 1 ml of injection solution contain the following amount of active compounds:

thiamine (B1) – 50 mg;
pyridoxine (B6) – 50 mg;
cobalamin (B12) – 0.5 mg;
lidocaine (anesthetic) – 10 mg.

There are component differences between solid forms of drugs. Both medications contain vitamins B1 and B6 in an amount of 100 mg. But the Milgamma tablet complex does not include vitamin B12, and in the composition of the drug Combilipen cobalamin is present in a concentration of 0.002 mg. Medicines also differ in the type of solid release form: Milgamma is sold as dragees, Kombilipen as tablets.

Characteristics of Compligam

This is a drug that is used to treat and prevent diseases of the nervous system. It belongs to 2 groups - vitamins and agents that have tonic properties. Release forms: tablets and solution in injection ampoules. The drug contains B vitamins.

Compligam affects foci of inflammation and degenerative processes in the central nervous system. The medicine is characterized by local anesthetic and analgesic properties, well saturates the body with B vitamins. This is facilitated by the components that make up the medicine:

Thiamine hydrochloride (vitamin B1). It influences the metabolic processes occurring in nerve tissues. Participates in carbohydrate metabolism.
Cyanocobalamin (vitamin B12). Reduces pain, stimulates nucleic acid metabolism and hematopoiesis.
Pyridoxine hydrochloride (vitamin B6). Participates in the metabolism of proteins, fats and carbohydrates.
Lidocaine. Has a local anesthetic effect.
Nicotinamide (vitamin B3). Improves joint function and blood microcirculation, dilates small vessels, reduces pain in osteoarthritis.
Riboflavin (vitamin B2). Promotes the production of red blood cells, helps restore body tissues.
Folic acid (vitamin B9). Supports the functioning of the immune system and hematopoiesis, helps with psoriasis.
Pantothenic acid (vitamin B5). Helps the functioning of blood vessels, the heart and the nervous system, takes part in the metabolism of fats, carbohydrates and proteins.

The drug is quickly absorbed and penetrates the blood, where it begins to be distributed among leukocytes, erythrocytes and plasma. Some components are able to bind to blood plasma proteins and penetrate the placental and blood-brain barriers.

Indications for use:

neuritis and polyneuritis;
disruption of nerve function and damage due to diabetes and alcohol intoxication;
muscle pain;
severe pain resulting from compression of the spinal roots;
irritation and pinched nerve with paroxysmal pain;
inflammation of the nerve ganglion;
damage to the nerve plexuses;
cramps at night;
lumboischialgia, radiculopathy.

Indications for use of Compligam: neuritis and polyneuritis.

The injections are given intramuscularly, the tablets are taken without crushing or chewing. Rapid administration of the solution leads to systemic reactions: dizziness, convulsions, arrhythmia.

Contraindications include:

pregnancy;
breastfeeding period;
age up to 12 years;
heart failure;
hypersensitivity to the components of the product.

Taking the drug can lead to the development of the following adverse reactions:

allergic reactions;
Quincke's edema;
disorientation;
vomiting, dyspepsia, nausea;
acne;
tachycardia;
heavy sweating;
anaphylactic shock;
angioedema;
labored breathing;
swelling, hyperemia, burning, urticaria, itching;
diplopia, collapse;
transverse heart block;
mental excitement;
feeling of heat or cold, bradycardia;
drowsiness;
diarrhea;
increased blood pressure;
photophobia;
nervousness.

Doctors prohibit the simultaneous use of Compligam and alcohol, as the load on the liver increases. The solution contains lidocaine, which in combination with alcohol enhances the effect of the anesthetic, leading to blockage of the respiratory center and death.

Treatment of acute back pain: B vitamins or NSAIDs?

Interest in the widespread use of a combination of B vitamins for pain came from practice. Since 1950, in many countries they have been considered analgesics. It is well known that B vitamins are neurotropic and significantly affect processes in the nervous system (metabolism, metabolism of mediators, transmission of excitation). In domestic practice, B vitamins are used very widely. Clinical experience shows that parenteral use of a combination of thiamine, pyridoxine and cyanocobalamin relieves pain well, normalizes reflex reactions, and eliminates sensitivity disorders. Therefore, for pain syndromes, doctors often resort to using vitamins of this group, both as monotherapy and in combination with other drugs. The popularity of B vitamins for acute back pain is also associated with other aspects. In daily work, this category of patients often has to face certain difficulties. Firstly, these are various complications of pharmacotherapy. The use of numerous NSAIDs is often rejected by patients themselves due to side effects, mainly from the gastrointestinal tract. Secondly, if any drug is ineffective, drugs from several groups must be prescribed simultaneously, which increases the risk of side effects and also increases the cost of treatment. Thirdly, many patients have contraindications to various pain-relieving physiotherapeutic procedures (electrotherapy, magnetic therapy, thermal procedures, etc.). Often patients cannot leave the house due to pain, and thus carrying out any procedures outside the home is excluded. In addition, it is not always possible to carry out the necessary muscle or epidural blockades due to the lack of appropriate conditions or specialists. There are more than 90 studies indicating clinical improvement with the use of B vitamins in patients with acute back pain [1–5]. However, many questions remain regarding the use of a combination of B vitamins in the treatment of acute back pain. How can B vitamins help with acute pain? What is their mechanism of action? How quickly does the effect occur? How safe is the combination of these vitamins? Can they be combined with NSAIDs? Is this combination treatment more effective than monotherapy? The purpose of this work (a randomized open comparative study) was to study the effectiveness of the drug Milgamma (Wörwag Pharma, Germany), diclofenac and their combination in the treatment of acute pain in the low back. The drug Milgamma is available in ampoules of 2.0 ml. One ampoule contains 100 mg of thiamine hydrochloride, 100 mg of pyridoxine hydrochloride, 1000 mcg of cyanocobalamin and 20 mg of lidocaine in a fairly small volume of solution. The difference between Milgamma and other vitamin preparations is its release form: one ampoule contains large doses of vitamins B1, B6 and B12 in combination with a local anesthetic. The decisive factor in the combined use of B vitamins is that the areas of application of B vitamins overlap and complement each other. The study material consisted of 60 patients suffering from acute back pain. The inclusion criterion was acute back pain with an intensity of at least 6 points on the visual analogue scale (VAS). Exclusion criteria were: cancer; back pain caused by pathology of the abdominal and pelvic organs, compression of the spinal cord. All patients were divided into three groups. The first group (“M”) included 20 patients who received 2.0 ml of the drug Milgamma for up to 10 days, the second group (“D”) included 20 patients who took intramuscular diclofenac 75 mg for up to 10 days. day, in the third group (“M + D”) - 20 patients who received daily injections of Milgamma (2.0 ml) and diclofenac (75 mg). The drug diclofenac was chosen for comparison as the most popular painkiller from the NSAID group, widely used in our country to relieve back pain. No other pharmacological drugs and/or physical procedures were prescribed to patients in both groups. Treatment was carried out on an outpatient basis. The maximum period for prescribing drugs is 10 days. If the pain syndrome was completely eliminated before this period, treatment was stopped. The average age in the “M” group was 42.8±9.9, in the “D” group – 40.0±9.8, in the “M + D” group – 43.1±10 years. In the “M” group there were 40% men and 60% women, in the “D” and “M + D” groups, respectively, 30% men and 70% women. Thus, the study groups were comparable in age and gender (p>0.15). Research methods. Clinical and neurological analysis, neuroimaging (MRI, CT, radiography), visual analogue scale (VAS) to assess the intensity of pain (daily), a scale of patient impressions about the effectiveness of therapy, and analysis of side effects of therapy were used. Statistical analysis was carried out using parametric and nonparametric statistical methods (Statistica 5.0 program). Results The pain syndrome was represented mainly by muscle-tonic disorders (100% in all groups). Radicular pain due to discogenic compression was observed: in groups “M” and “D” in 10% of cases, in group “M + D” in 20% of cases. At the same time, intervertebral disc herniation was detected on MRI: in group “M” in 10% (L5–S1), in group “D” in 20% (L5–S1), in group “M + D” in 20% of cases (L4 –L5, L5–S1). The phenomena of osteochondrosis occurred in 95%, in group “D” in 100%, in group “M + D” in 95% of cases. The intensity of pain before treatment and the dynamics of VAS scores during the course of treatment in the study groups are presented in Table 1 and Figure 1. The intensity of pain according to VAS in the compared groups before treatment did not differ significantly. In groups “M” and “D” there was a statistically significant decrease in pain intensity according to VAS starting from the second day of therapy and its subsequent highly significant decrease throughout the course of treatment (p<0.001). In the “M + D” group, a significant reduction in pain was noted already from the first day of therapy. Comparing the overall effectiveness of treatment in the studied groups, one can note a significant and consistent reduction in pain throughout all days of therapy. To assess the dynamics of pain reduction, an analysis of changes in VAS was carried out as a percentage in relation to the intensity of pain before treatment, taken as 100% (Table 2). By the third day of treatment, all groups achieved a clinically significant reduction in pain for patients (by more than 30%). It should be noted that the greatest changes (reduction of pain) were observed during the first three days, but these differences did not reach the level of significance. There is an opinion among doctors that diclofenac is more effective than Milgamma for very intense pain. To test this hypothesis, we compared the effectiveness of treatment in three groups in patients with an initial pain intensity of 8–10 points on the VAS. When analyzing the dynamics of pain regression in these patients (8–10 points on VAS), a significant decrease in pain intensity was observed in all groups within the first 5 days. However, if we evaluate the degree of pain relief by days of therapy, we notice a positive effect on the first day of therapy in the “M + D” group (p <0.05), while in the “M” and “D” groups a significant reduction in pain was noted only from the second day of treatment (Table 3). In our work, we analyzed the number of patients with varying degrees of pain regression: with complete relief (100%), with regression by 50% and 30%, depending on the duration of therapy (Table 4). It should be emphasized here that a 30% reduction in pain is considered a clinically significant improvement. On the second day of therapy, clinically significant improvement was noted by 11 people in the “M + D” group, which is significantly more than on this day in the “M” and “D” groups (p < 0.05). As can be seen from the table, in the “M + D” group there were more patients with complete pain relief during the first 5 days of treatment. However, it can be noted that starting from 4–5 days of treatment, the number of patients with pain regression of more than 30% was approximately the same in the three groups. Patients were also asked to independently evaluate the analgesic effect of the drugs on a scale of subjective impressions (Table 5, Fig. 2 and 3). In general, following the results of 10 days of treatment in group “M”, 45% of patients noted complete elimination of pain, in group “D” there were 35%, however, the largest number of patients with complete regression of pain was in group “M + D” (70%) . The fact that pain decreased slightly was reported by 10% of patients taking diclofenac or Milgamma alone. In the group receiving diclofenac, one patient's pain persisted for 7 days of treatment and the patient was hospitalized. During the treatment period, adverse reactions were detected in a number of patients. The most common side effects were epigastric pain and diarrhea (Table 6). Analysis of adverse reactions showed that most of them are associated with taking diclofenac. Their number was significantly higher in the group taking diclofenac (35%) and the group on two drugs (25%) compared to the group receiving Milgamma (5%). Due to side effects, 20% in the “D” group abandoned therapy (10% after the 5th injection, 10% after the 7th injection), 15% in the “M + D” group (after 5 days of treatment), 5% – in group “M” (after the 7th injection). Thus, a significantly higher number of patients discontinued treatment due to side effects associated with diclofenac. Discussion With a normal and varied diet, the intake of vitamins into the body is quite sufficient to prevent any vitamin deficiency. With the advent of synthetic vitamins, it became possible to obtain in one dose of the drug the amount of vitamins that a person could get from food for a year. However, at these pharmacological doses, vitamins should be considered as drugs. And what is very important is that at these doses their mechanism of action often turns out to be different from the well-known physiological effect that is usually considered when analyzing the mechanisms of action of vitamins [6]. There are two groups of disorders for which vitamin therapy is unconditionally indicated. First: vitamin deficiency conditions (beriberi, pellagra, alcoholism, malabsorption, cystic fibrosis, etc.). Second: genetic defects in vitamin metabolism. Moreover, both of these groups of vitamin deficiency conditions constitute a very small part of all prescriptions for vitamin preparations. However, in medical practice, B vitamins are most often prescribed as adjuvants for conditions that are not accompanied by vitamin deficiency: pain syndromes, psychoses, asthenia, tunnel syndromes, alopecia. Very often, good treatment results are achieved. However, it remains unclear in which cases the positive effect is associated with the action of vitamins, may be random, or due to a placebo effect. There is no convincing scientific evidence yet to prove that positive results are associated with the action of vitamin preparations. However, clinical and experimental studies are currently underway on the use of vitamins as active drugs, with new mechanisms of action [7–9]. Experimental work studying the effects of a combination of vitamins B1, B6 and B12 on pain showed inhibition of nociceptive responses caused by formaldehyde, which did not change after administration of naloxone. It has been suggested that the antinociceptive effect of the combined vitamin complex may be due to inhibition of synthesis and/or blocking the action of inflammatory mediators [7]. Many studies emphasize that both combination and separate use of vitamins B1, B6 and B12 have an analgesic effect. It has been shown that the B complex of vitamins enhances the effect of norepinephrine and serotonin, the main antitinociceptive neurotransmitters. In addition, the experiment revealed suppression of nociceptive responses not only in the dorsal horn, but also in the thalamus optica [8]. It was also found that this combination of vitamins is able to enhance the antinociceptive effects of non-opioid analgesics in the study of protective reflexes. Despite the fact that there are no large evidence-based studies in this regard, practice shows that these vitamins in large doses do have analgesic properties, and can also enhance the analgesic effects when used simultaneously with simple analgesics or NSAIDs. Positive results were obtained in the treatment of both musculoskeletal pain and neuropathic pain [9]. In particular, there are studies showing the effectiveness of vitamin B6 in carpal tunnel syndromes. There are indications that B vitamins enhance analgesia when used concomitantly with diclofenac for acute back pain, which may shorten treatment time and reduce dosages of diclofenac, thus reducing the risk of side effects [10–13]. Another control study of the combined use of diclofenac (50 mg) and B complex vitamins (B1 - 50 mg, B6 - 50 mg, B12 - 0.25 mg) for two weeks showed that 29 patients stopped treatment early due to complete regression of pain [11]. Of these, 65% of patients received combination therapy, and 35% received diclofenac only. It was also noted that in the combined group, after three days of treatment, the severity of pain decreased according to the subjective report of the patients. Side effects were observed in 39 patients in this study; 14 patients stopped treatment early for this reason. Thus, the role of B vitamins in enhancing the analgesic effect is emphasized. The results obtained in our work confirmed the effectiveness and safety of the combined drug Milgamma in the treatment of acute back pain. A reliable analgesic effect is observed from the 2nd injection of the drug. The effect of Milgamma, a drug not related to painkillers, turned out to be comparable to diclofenac, a “classical” painkiller. This may indicate that the combination of B vitamins in Milgamma has a clear analgesic mechanism of action and is not the result of the usual traditional physiological effects of these vitamins. This position seems very important to us, since it is widely believed among doctors that the use of B vitamins for acute pain is ordinary vitamin therapy aimed at “strengthening the nervous system.” Taking into account the new experimental data mentioned above, we can expect that in the future the analgesic properties will be studied in more detail and the mechanisms of action of large doses of B vitamins in humans will be clarified. In our work, side effects and complications during and after the end of therapy were associated with taking diclofenac. In the group of patients taking diclofenac, a high percentage (35%) of side effects was observed, which, unfortunately, confirms its poor safety profile. As for combination therapy, it turned out to be more effective than monotherapy in terms of the dynamics of pain regression. A faster and more pronounced reduction in pain in the first days of therapy has been shown, which is especially important for intense pain. It is likely that combination therapy can shorten treatment time, and also allows us to discuss the use of lower doses of NSAIDs when combined with Milgamma. The combination of Milgamma with diclofenac can be recommended for very high pain intensity for its rapid relief in the first days of treatment. However, it should be noted that the effectiveness of Milgamma monotherapy for intense pain was not inferior to diclofenac, and this, taking into account the better safety profile, makes this drug universal for both mild and severe pain. Conclusions The study confirms clinical experience of the high effectiveness of a combination of B vitamins in the treatment of acute back pain. Monotherapy with Milgamma for acute back pain is accompanied by a significant decrease in the intensity of the pain syndrome from the second day and throughout the entire course of treatment with a virtual absence of undesirable side effects. Milgamma is an effective pain reliever for both moderate and high intensity pain. Treatment of acute back pain with diclofenac is effective, but in a third of cases it is accompanied by unwanted side effects, which should be taken into account when choosing medications. Combination therapy with diclofenac and Milgamma provides a more pronounced analgesic effect than monotherapy (Milgamma or diclofenac); a positive effect is observed already on the first day of therapy, which is important to consider if urgent pain relief is necessary. It is likely that combination therapy (NSAIDs + B vitamins) will allow the use of lower doses of NSAIDs to prevent unwanted side effects while achieving maximum pain relief. With a treatment duration of 7–10 days, combination therapy has no advantages over monotherapy with Milgamma or diclofenac in terms of the final result, however, monotherapy with Milgamma is better tolerated and safe. Milgamma injection should be considered not as a component for the treatment of vitamin deficiency conditions or a general tonic, but as an active agent with special but obvious analgesic properties.

References 1. Dordain G, Aumaitre O, Eschalier A, Decamps A. Vitamin B12, an analgesic vitamin? Critical examination of the literature. Acta Neurol Belg. 1984 Jan–Feb;84(1):5–11. 2. Mauro GL, Martorana U, Cataldo P, Brancato G, Letizia G. Vitamin B12 in low back pain: a randomized, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci. 2000 May–Jun;4(3):53–8. 3. Bromm K, Herrmann WM, Schulz H. Do the B-vitamins exhibit antinociceptive efficacy in men? Results of a placebo-controlled repeated-measures double-blind study. Neuropsychobiology. 1995;31(3):156–65. 4. Eckert M, Schejbal P. Therapy of neuropathies with a vitamin B combination. Symptomatic treatment of painful diseases of the peripheral nervous system with a combination preparation of thiamine, pyridoxine and cyanocobalamin. Fortschr Med. 1992 Oct 20;110(29):544–8. 5. Jurna I. Analgesic and analgesia–potentiating action of B vitamins. Schmerz. 1998 Apr 20;12(2):136–41 6. Lemoine A, Le Devehat C. Clinical conditions requiring elevated dosages of vitamins. : Int J Vitam Nutr Res Suppl. 1989;30:129–47. 7. Franca DS, Souza AL, Almeida KR, Dolabella SS, Martinelli C, Coelho MM. B vitamins induce an antinociceptive effect in the acetic acid and formaldehyde models of nociception in mice. Eur J Pharmacol. 2001 Jun 15;421(3):157–64. 8. Jurna I, Carlsson KH, Komen W, Bonke D. Acute effects of vitamin B6 and fixed combinations of vitamin B1, B6 and B12 on nociceptive activity evoked in the rat thalamus: dose–response relationship and combinations with morphine and paracetamol.: Klin Wochenschr. 1990 Jan 19;68(2):129–35. 9. Wang ZB, Gan Q, Rupert RL, Zeng YM, Song XJ. Thiamine, pyridoxine, cyanocobalamin and their combination inhibit thermal, but not mechanical hyperalgesia in rats with primary sensory neuron injury. Pain. 2005 Jul;116(1–2):168; p.169. 10. Rocha–Gonzalez HI, Teran–Rosales F, Reyes–Garcia G, Medina–Santillan R, Granados–Soto V. B vitamins increase the analgesic effect of diclofenac in the rat. Proc West Pharmacol Soc. 2004;47:84–7. 11. Vetter G, Bruggemann G, Lettko M et al.. Shortening diclofenac therapy by B vitamins. Results of a randomized double–blind study, diclofenac 50 mg versus diclofenac 50 mg plus B vitamins, in painful spinal diseases with degenerative changes] : Z Rheumatol. 1988 Sep–Oct;47(5):351–62. 12. Bruggemann G, Koehler CO, Koch EM. Results of a double–blind study of diclofenac + vitamin B1, B6, B12 versus diclofenac in patients with acute pain of the lumbar vertebrae. A multicenter study. Klin Wochenschr. 1990 Jan 19;68(2):116–20. 13. Kuhlwein A, Meyer HJ, Koehler CO. Reduced diclofenac administration by B vitamins: results of a randomized double–blind study with reduced daily doses of diclofenac (75 mg diclofenac versus 75 mg diclofenac plus B vitamins) in acute lumbar vertebral syndromes. Klin Wochenschr. 1990 Jan 19;68(2):107–15.

Characteristics of Kombilipen

This is a drug that belongs to 2 pharmacological groups - vitamins and general tonics. The medication contains the following active ingredients: thiamine hydrochloride, lidocaine hydrochloride, pyridoxine hydrochloride, cyanocobalamin. Release forms: solution for intramuscular administration and tablets.

Combilipen belongs to 2 pharmacological groups - vitamins and general tonics.

Combilipen is a combined vitamin remedy that is used for diseases of the nervous system. It is able to increase the body's resistance to adverse internal and external factors.

The B vitamins included in the drug have the following properties:

restore the myelin sheaths of nerve fibers;
normalize the metabolism of fats, proteins and carbohydrates;
reduce pain caused by damage to the peripheral nervous system;
help restore damaged nerve tissue;
improve the conduction of nerve impulses;
normalize the production of neurotransmitters, which are responsible for the processes of inhibition and excitation in the central nervous system.

Indications for use:

multiple lesions of the peripheral nervous system;
inflammation of nerve trunks caused by diseases of the spine (intercostal neuralgia, cervicobrachial syndrome, lumbago, radicular syndrome, radiculitis, etc.);
shingles;
neuritis of the facial nerve;
pain due to pathology of the trigeminal nerve.

Contraindications include:

pregnancy;
breastfeeding period;
heart failure;
excessive sensitivity to the components of the product;
age up to 12 years.

Combilipen is most often well tolerated, but sometimes the following adverse reactions of the body may develop:

hives;
increased sweating;
acne;
tachycardia;
feeling of heartbeat;
anaphylactic shock;
Quincke's edema.

During the course of treatment, it is necessary to avoid drinking alcohol, as it interferes with the absorption of B vitamins.

Comparison of Compligam and Combilipen

To find out which drug is more effective, you need to compare them.

Similarities

Compligam and Combilipen are combination drugs and multivitamin complexes that have a neurotropic effect. They affect the nervous and motor systems and help in the treatment of inflammatory and degenerative diseases. Correctly selected dosage helps to increase blood circulation and improve the functioning of the nervous system.

The dosage form of the medications is the same - tablets and solution in injection ampoules. The course of injections is 5-10 days, taking tablets can last 1 month. They have the same contraindications. The drugs should be taken with caution in case of diabetes mellitus. Incorrect use can lead to overdose.

What is the difference?

The difference between the medications is that Compligam contains active ingredients such as vitamins B2, B3, B9, B5, which are absent in Combilpen. They have different manufacturers. Compligam is produced by Pharm CJSC (Russia), Kombilipen is produced by Pharmstandard OJSC (Russia). In addition, Combilipen has fewer side effects.

Which is cheaper?

The price of Compligam is 180 rubles, Kombilipena is 330 rubles.

Other analogues

In pharmacies you can choose drugs that have the same component composition as the Combilipen and Milgamma complexes, which act in the same way as the original medications. Among the analogues we can note:

Neurobex;
Neurobion;
Neurorubin;
Vitagamma;
Compligam B;
Vitaxon.

Which is better - Compligam or Combilipen?

These drugs are analogues with the same beneficial properties. Therefore, only the doctor should decide which drug is best to prescribe, taking into account the characteristics of the patient’s body.

In injections

Both medications contain lidocaine, which helps reduce pain in the injection area and dilate blood vessels, facilitating the rapid entry of drug components into the general bloodstream. If necessary, drugs can replace each other. But this can only be done as prescribed by a doctor.

Patient reviews

Serafima, 35 years old, Moscow: “The doctor prescribed the drug Compligam in injections to calm my nerves. She underwent a course of treatment that lasted a week. My health improved, and even my nails and hair began to look much better. There were no adverse reactions. I want to take another course in six months to consolidate the results.”

Mikhail, 51 years old, Voronezh: “I have neuralgia of the femoral nerve. The pain was so severe that the whole leg went numb. The doctor prescribed Kombilipen injections. They injected him for 3 days, after which the numbness and pain went away. I haven’t remembered this disease for 2 years now.”

Treatment for adults

You cannot combine Combilipen with Compligam at the same time : there will be hypervitaminosis with a pronounced manifestation of its symptoms. At the beginning of the treatment of acute diseases, injections with one drug are prescribed, then the patient is transferred to B complex tablets or Tabs.

Dosage and course of treatment

Injections of Combilipen or Compligam B are given at 2 ml/day for the first 5–10 days. Then transfer to injections with a frequency of 2-3 times/week. The general course of use is one month.

In the attenuation phase, instead of injections, the drug may be prescribed orally. Combilipen Tabs is taken one tablet after meals three times a day. Do not chew the product, wash it down with 30–70 ml of water. The course of treatment is up to a month.

Compligam B Complex is taken once a day, one tablet during meals. Take 50 ml of water. Take no longer than a month.

Reviews from doctors on Compligam and Combilipen

Dmitry, 44 years old, therapist, St. Petersburg: “I often prescribe the drug Compligam in my practice for radiculitis and pinched sciatic nerve. This remedy helps to quickly relieve back pain. In addition, it is used in the treatment of neuropathy, ganglionitis and myalgia.”

Tatyana, 49 years old, neurologist, Sochi: “I consider Combilipen an effective vitamin preparation. It helps well with polyneuropathy, nerve damage, and relieves pain. The doses are chosen correctly, so overdose is excluded. This drug rarely causes the development of adverse allergic reactions.”

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